Infertility affects an estimated 48 million couples globally and assisted reproductive technology (ART) has developed as a prominent treatment option. Concerns regarding pregnancy problems related to ART have grown as mother age had increased, as had prepregnancy cardiovascular risk factors such as chronic hypertension, obesity, and diabetes. In-hospital problems following ART pregnancies, on the other hand, were poorly documented. Researchers evaluated hospital deliveries conceived with or without ART between January 1, 2008, and December 31, 2016, from the United States National Inpatient Sample database to determine patient characteristics, obstetric outcomes, vascular complications, and temporal trends of pregnancies conceived by ART. They included 106,248 ART-conceived pregnancies and 34,167,246 non-ART-conceived pregnancies in the research. Women who conceived through assisted reproductive technology (ART) were older (35 vs. 28 years; P<0.0001) and had more comorbidities. ART-conceived pregnancies were linked to vascular complications (acute kidney injury: adjusted odds ratio [aOR], 2.52; 95% CI, 1.99–3.19; and arrhythmia: aOR, 1.65; 95% CI, 1.46–1.86) and adverse obstetric outcomes (placental abruption: aOR, 1.57; 95% CI, 1.41–1.74; cesarean delivery: aOR, 1.38; 95% CI, 1.33–1.43; and preterm birth: aOR, 1.26; 95% CI, 1.20–1.32), including in subgroups without cardiovascular disease risk factors or without multifetal pregnancies. Compared with women who conceived without ART, hospital costs increased ($18,705 vs. $11,983; P<0.0001). Compared with spontaneous conception, ART-conceived pregnancies had a higher risk of unfavorable obstetric outcomes and vascular problems. During prenatal counseling, clinicians should have been in-depth conversations about the consequences of ART in women.
Source – www.ahajournals.org/doi/10.1161/JAHA.121.022658
